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https://www.readbyqxmd.com/read/29221961/prevalence-of-high-on-treatment-aspirin-and-clopidogrel-platelet-reactivity-in-patients-with-critical-limb-ischemia
#1
Leonardo C Clavijo, Noor Al-Asady, Ashwat Dhillon, Ray V Matthews, Jorge Caro, Han Tun, Vincent Rowe, David M Shavelle
OBJECTIVES: The goal of this study is to establish the prevalence of high on-treatment platelet reactivity to aspirin (HPRA) and clopidogrel (HPRC) in patients with critical limb ischemia (CLI). BACKGROUND: CLI is associated with an increased risk of death and cardiovascular events. Unlike other patient populations with atherosclerotic cardiovascular disease, previous studies failed to demonstrate a benefit of antiplatelet therapy in patients with CLI. METHODS: From June 2014 to November 2016, we performed platelet reactivity studies for P2Y12 and thromboxane A2 (TXA2) inhibition in 100 CLI patients receiving daily treatment with aspirin and clopidogrel...
October 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29221946/-facing-a-dilemma-in-elderly-complex-and-vulnerable-patients-to-stop-or-not-to-stop-prevention
#2
Laura Llobet Vila, Josep Maria Manresa Domínguez, José Manuel Carmona Segado, Alícia Franzi Sisó, Rosa Vallès Balasch, Isabel Martínez Díaz
OBJECTIVES: 1-To know the preventive prescription (statin, antiplatelet drugs, bisphosphonates, calcium and vitamin D and Vit B12) of elderly patients previously identified as a CCD (with a complex chronic disease) and ACD (with advanced chronic disease and lifetime expectancy of less than 12 months) who died during 2015. 2-To assess the correct indication of Proton Pump Inhibitors (PPI) to determine potentially avoidable medication. DESIGN: Retrospective observational study...
December 5, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29216997/the-state-of-the-absorb-bioresorbable%C3%A2-scaffold-consensus-from-an-expert-panel
#3
REVIEW
Sripal Bangalore, Hiram G Bezerra, David G Rizik, Ehrin J Armstrong, Bruce Samuels, Srihari S Naidu, Cindy L Grines, Malcolm T Foster, James W Choi, Barry D Bertolet, Atman P Shah, Rebecca Torguson, Surendra B Avula, John C Wang, James P Zidar, Aziz Maksoud, Arun Kalyanasundaram, Steven J Yakubov, Bassem M Chehab, Anthony J Spaedy, Srini P Potluri, Ronald P Caputo, Ashok Kondur, Robert F Merritt, Amir Kaki, Ramon Quesada, Manish A Parikh, Catalin Toma, Fadi Matar, Joseph DeGregorio, William Nicholson, Wayne Batchelor, Raghava Gollapudi, Ethan Korngold, Riyaz Sumar, George S Chrysant, Jun Li, John B Gordon, Rajesh M Dave, Guilherme F Attizzani, Tom P Stys, Osvaldo S Gigliotti, Bruce E Murphy, Stephen G Ellis, Ron Waksman
Significant progress has been made in the percutaneous coronary intervention technique from the days of balloon angioplasty to modern-day metallic drug-eluting stents (DES). Although metallic stents solve a temporary problem of acute recoil following balloon angioplasty, they leave behind a permanent problem implicated in very late events (in addition to neoatherosclerosis). BRS were developed as a potential solution to this permanent problem, but the promise of these devices has been tempered by clinical trials showing increased risk of safety outcomes, both early and late...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29215418/switching-from-ticagrelor-or-prasugrel-to-clopidogrel
#4
James J Nawarskas, Tiffany N Montoya
Ticagrelor and prasugrel are newer antiplatelet drugs which, like clopidogrel, block the P2Y12 platelet receptor in order to inhibit platelet aggregation. Compared to clopidogrel, ticagrelor and prasugrel both have greater clinical efficacy but also have a higher risk of bleeding and are much more costly. Therefore, some institutions and providers switch patients from ticagrelor or prasugrel to clopidogrel in an effort to lower bleeding risk, stem costs, or otherwise ensure that patients can safely adhere to long-term P2Y12 inhibitor therapy...
December 5, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/29212315/post-ercp-bleeding-in-the-era-of-multiple-antiplatelet-agents
#5
Hyoung-Chul Oh, Ihab I El Hajj, Jeffrey J Easler, James Watkins, Evan L Fogel, Lee McHenry, Glen A Lehman, Jung Sik Choi, Hyun Kang, Stuart Sherman
Background/Aims: This study aimed to determine the risk of post-endoscopic retrograde cholangiopancreatography (post-ERCP) bleeding among patients taking antiplatelet agents (APAs), particularly in the era of multiple APAs. Methods: The primary outcomes were the frequency, type, and severity of ERCP-related bleeding according to the use of APAs. Results: The frequencies of post-ERCP bleeding among the four different groups were 16 of 2,083 (0...
December 8, 2017: Gut and Liver
https://www.readbyqxmd.com/read/29208494/bleeding-in-advanced-ckd-patients-on-antithrombotic-medication-a-critical-appraisal
#6
Alexandru Burlacu, Simonetta Genovesi, David Goldsmith, Patrick Rossignol, Alberto Ortiz, Philip A Kalra, Jolanta Małyszko, Maciej Banach, Mehmet Kanbay, Adrian Covic
Patients with advanced chronic kidney disease (CKD) are at an increased risk of bleeding, especially in the context of the complex therapeutic schemes of coronary artery disease (CAD) (from stable angina to acute coronary syndromes), atrial fibrillation or venous thromboembolism. The bleeding issue increases morbidity and mortality, a serious problem in daily medical practice. However, these patients are largely excluded from major randomized clinical trials, which results in the lack of medical evidence-based foundation for specific recommendations regarding antithrombotic treatment in a high bleeding risk setting...
December 2, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29206871/clopidogrel-in-a-combined-therapy-with-anticancer-drugs-effect-on-tumor-growth-metastasis-and-treatment-toxicity-studies-in-animal-models
#7
Agnieszka Denslow, Marta Świtalska, Joanna Jarosz, Diana Papiernik, Kseniia Porshneva, Marcin Nowak, Joanna Wietrzyk
Clopidogrel, a thienopyridine derivative with antiplatelet activity, is widely prescribed for patients with cardiovascular diseases. In addition to antiplatelet activity, antiplatelet agents possess anticancer and antimetastatic properties. Contrary to this, results of some studies have suggested that the use of clopidogrel and other thienopyridines accelerates the progression of breast, colorectal, and prostate cancer. Therefore, in this study, we aimed to evaluate the efficacy of clopidogrel and various anticancer agents as a combined treatment using mouse models of breast, colorectal, and prostate cancer...
2017: PloS One
https://www.readbyqxmd.com/read/29201206/combined-treatment-of-diabetic-nephropathy-with-alprostadil-and-calcium-dobesilate
#8
Lili Qin, Wenjun Qin, Jianfei Wang, Lin Lin
This study investigated the effects of alprostadil combined with calcium dobesilate on the treatment of diabetic nephropathy. We recruited 80 patients with diabetic nephropathy, who were randomly divided into experimental (n=40) and control (n=40) groups. Patients received high-quality low-protein diabetic diet intervention and subcutaneous injection of insulin to adjust blood glucose, combined with antihypertensive, antiplatelet drugs, and other comprehensive treatments. The control group received alprostadil and the experimental group received alprostadil combined with calcium dobesilate...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29198986/australian-trends-in-procedural-characteristics-and-outcomes-in-patients-undergoing-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction
#9
Sinjini Biswas, Stephen J Duffy, Jeffrey Lefkovits, Nick Andrianopoulos, Angela Brennan, Antony Walton, William Chan, Samer Noaman, James A Shaw, Luke Dawson, Andrew Ajani, David J Clark, Melanie Freeman, Chin Hiew, Ernesto Oqueli, Christopher M Reid, Dion Stub
Over the last decade, systems of care for ST-elevation myocardial infarction (STEMI) have evolved to try to improve outcomes and timely access to percutaneous coronary intervention (PCI). There have also been advances in PCI techniques and adjunctive pharmacotherapies. In this study, we sought to determine temporal changes in practices and clinical outcomes of PCI in patients with STEMI. We prospectively collected data on 8,412 consecutive patients undergoing PCI for STEMI between 2005 and 2016 in the multicenter Melbourne Interventional Group registry...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29198761/diagnostics-treatment-and-secondary-prevention-of-ischemic-stroke-in-the-silesian-province-poland-between-2009-and-2015
#10
Beata Łabuz-Roszak, Anna Starostka-Tatar, Anetta Lasek-Bal, Marek Gierlotka, Mariusz Gąsior, Michał Skrzypek
BACKGROUND: The available data on diagnostics and treatment of ischemic stroke (IS) in Poland come mainly from non-representative cohorts or are outdated. OBJECTIVE: Therefore, the current study was done to access the most recent data on IS in the industrial region that covers 12% of the country's population. MATERIALS & METHODS: Analysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to acute stroke and administered by the National Health Fund (the only public health insurer in Poland) between 2009 and 2015 (n=81,193)...
November 14, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29197128/a-remote-assay-for-measuring-canine-platelet-activation-and-the-inhibitory-effects-of-antiplatelet-agents
#11
M Dunning, J May, J Adamany, S Heptinstall, S Fox
BACKGROUND: Antiplatelet medications are increasingly used in dogs. Remote analysis of platelet activity is challenging, limiting assessment of antiplatelet drug efficacy. HYPOTHESIS/OBJECTIVES: To evaluate a method used in humans for stimulation and remote analysis of canine platelet activity. ANIMALS: Forty-five dogs of various ages without a coagulopathy or thrombocytopenia. Six were receiving antiplatelet medication. METHODS: Prospective observational study...
December 2, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29196125/prescription-patterns-and-costs-of-antidiabetic-medications-in-a-large-group-of-patients
#12
Andrés Gaviria-Mendoza, Jorge Andrés Sánchez-Duque, Diego Alejandro Medina-Morales, Jorge Enrique Machado-Alba
AIMS: To determine the prescription patterns of antidiabetic medications and the variables associated with their use in a Colombian population. METHODS: A cross-sectional study using a systematized database of approximately 3.5 million affiliates of the Colombian Health System. Patients of both genders and all ages treated uninterruptedly with antidiabetic medications for three months (June-August 2015) were included. A database was designed that included sociodemographic, pharmacological, comedication, and cost variables...
November 28, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/29186393/inappropriate-doses-of-direct-oral-anticoagulants-in-real-world-clinical-practice-prevalence-and-associated-factors-a-subanalysis-of-the-fantasiia-registry
#13
Martín Ruiz Ortiz, Javier Muñiz, Paula Raña Míguez, Inmaculada Roldán, Francisco Marín, María Asunción Esteve-Pastor, Angel Cequier, Manuel Martínez-Sellés, Vicente Bertomeu, Manuel Anguita
Aims: To describe the prevalence and associated factors of inappropriate doses of direct oral anticoagulants (DOAC) in a national registry of patients of real clinical practice. Methods and results: Five hundred and thirty outpatients with atrial fibrillation treated with DOAC were included in a prospective, national, multicentre study. The appropriateness of the doses of DOAC was defined according to the recommendations of the European Heart Rhythm Association...
November 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29183961/oral-anticoagulants-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#14
José A López-López, Jonathan A C Sterne, Howard H Z Thom, Julian P T Higgins, Aroon D Hingorani, George N Okoli, Philippa A Davies, Pritesh N Bodalia, Peter A Bryden, Nicky J Welton, William Hollingworth, Deborah M Caldwell, Jelena Savović, Sofia Dias, Chris Salisbury, Diane Eaton, Annya Stephens-Boal, Reecha Sofat
Objective To compare the efficacy, safety, and cost effectiveness of direct acting oral anticoagulants (DOACs) for patients with atrial fibrillation.Design Systematic review, network meta-analysis, and cost effectiveness analysis. Data sources Medline, PreMedline, Embase, and The Cochrane Library.Eligibility criteria for selecting studies Published randomised trials evaluating the use of a DOAC, vitamin K antagonist, or antiplatelet drug for prevention of stroke in patients with atrial fibrillation.Results 23 randomised trials involving 94 656 patients were analysed: 13 compared a DOAC with warfarin dosed to achieve a target INR of 2...
November 28, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29183523/hypoalbuminemia-and-clinical-outcomes-what-is-the-mechanism-behind-the-relationship
#15
REVIEW
Sunghye Kim, Stephen A McClave, Robert G Martindale, Keith R Miller, Ryan T Hurt
Albumin has a number of important physiologic functions, which include maintaining oncotic pressure, transporting various agents (fatty acids, bile acids, cholesterol, metal ions, and drugs), scavenging free oxygen radicals, acting as an antioxidant, and exerting an antiplatelet effect. Hypoalbuminemia in adults, defined by an intravascular albumin level of <3.5 g/dL, is associated with poor postoperative outcomes in patients undergoing surgical intervention. Although the relationship of hypoalbuminemia and poor surgical outcome has been known for many years, the pathophysiology behind the relationship is unclear...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29180679/risk-of-non-cardiac-surgery-after-percutaneous-coronary-intervention-with-drug-eluting-stents
#16
Sun-Kyung Park, Dhong Eun Jung, Sung Ae Jung, Won Ho Kim, Jae-Hyon Bahk
Elective non-cardiac surgery (NCS) should optimally be delayed one year after implantation of a drug-eluting stent (DES). Dual antiplatelet therapy or at least aspirin is recommended to be continued considering the relative risk of stent thrombosis especially during the 4 weeks after DES implantation. However, these recommendations were supported by insufficient evidence. We investigated predictors for postoperative major adverse cardiovascular and cerebral event (MACCE) in 1582 patients undergoing non-cardiac surgery after DES implantation...
November 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29170073/effect-of-intravenous-fentanyl-on-ticagrelor-absorption-and-platelet-inhibition-among-patients-undergoing-percutaneous-coronary-intervention-design-rationale-and-sample-characteristics-of-the-pacify-randomized-trial
#17
Khalil Ibrahim, Rakesh R Goli, Rohan Shah, Jon R Resar, Steven P Schulman, John W McEvoy
INTRODUCTION: Morphine reduces and delays the absorption of oral P2Y12 platelet inhibitors. Fentanyl is another opiate often administered during percutaneous coronary interventions (PCI). The PACIFY study will test whether intravenous fentanyl also impairs the absorption and action of oral P2Y12 inhibitors. METHODS: PACIFY is a single-center trial randomizing adults undergoing clinically-indicated coronary angiography to have the procedure with or without fentanyl...
November 21, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29169502/re-evaluating-the-safety-of-drug-eluting%C3%A2-stents-in-cancer-patients
#18
REVIEW
Sarju Ganatra, Ajay Sharma, Michael S Levy
Evidence increasingly shows that cancer and coronary artery disease are interlinked through common risk factors, co-occurrence in an aging population, and through the deleterious effects of cancer treatment on cardiovascular health. Many of the clinical risk factors for cancer, such as diabetes, smoking, and chronic inflammatory state, are also risk factors for coronary artery disease and for stent restenosis and thrombosis. The current generations of drug-eluting stents have been proven to reduce the risk of restenosis and stent thrombosis as compared with bare-metal stents...
November 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29169331/prescription-of-secondary-preventive-drugs-after-ischemic-stroke-results-from-the-malaysian-national-stroke-registry
#19
Wen Yea Hwong, Zariah Abdul Aziz, Norsima Nazifah Sidek, Michiel L Bots, Sharmini Selvarajah, L Jaap Kappelle, Sheamini Sivasampu, Ilonca Vaartjes
BACKGROUND: Evaluation of secondary stroke prevention in low and middle-income countries remains limited. This study assessed the prescription of secondary preventive drugs among ischemic stroke patients upon hospital discharge in Malaysia and identified factors related to the prescribing decisions. METHODS: From Malaysian National Stroke Registry, we included patients with non-fatal ischemic stroke. Prescriptions of antiplatelet, anticoagulants, antihypertensive drugs and lipid-lowering drugs were assessed...
November 23, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29169069/anti-inflammatory-agents-in-peripheral-arterial-disease
#20
REVIEW
Alexios S Antonopoulos, Evi Papanikolaou, Georgia Vogiatzi, Evangelos Oikonomou, Dimitris Tousoulis
Inflammation is pivotally involved in coronary and peripheral atherosclerotic disease. This established concept is based on both experimental animal models of vascular inflammation and Mendelian randomization studies demonstrating a causal relationship between pro-inflammatory cytokines (e.g. interleukin-6) and cardiovascular disease risk. More recently, the reduction of cardiovascular events by use of an interleukin-1β inhibitor (canakinumab) has revived interest in the use of anti-inflammatory agents for the treatment of atherosclerotic disease, including peripheral arterial disease...
November 20, 2017: Current Opinion in Pharmacology
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